NC Supreme Court Rules Nurses Can Face Legal Liability for Following Doctor’s Orders

In a split decision, the North Carolina Supreme Court ruled that nurses can be held liable for medical errors and mistakes – even if they were carrying out the doctor’s orders. The ruling strikes down a 90-year-old legal precedent protecting nurses and healthcare workers from prosecution related to these kinds of incidents.

The case, Connette v. Charlotte-Mecklenburg Hospital Authority, centered on the death of Amaya Gullatte, a 3-year-old patient, who was treated at Carolinas Medical Center in 2010.

“They gave her anesthesia, which was the biggest danger she had,” said John Edwards, the attorney representing the family. “Her heart stopped as a result of the anesthesia. She ended up being without oxygen and blood to her brain for about 12 or 13 minutes.”

The procedure left her with permanent brain damage, cerebral palsy, and developmental delays.

The family sued the hospital and the nurse anesthetist that performed the procedure, but legal action against the nurse was blocked by Byrd v. Marion General Hospital, the 90-year-old precedent that protects nurses when working under a doctor’s supervision.

Now, the state’s Supreme Court has struck down that precedent by saying the nurse can be held legally liable for administering the anesthesia.

“The short version is, every single one of us, including you and me, we’re legally responsible for what we do,” Edwards said. “What the North Carolina Supreme Court said, Friday, was, we’re going to do the same thing for all healthcare providers treat them all exactly the same.”

The court ruled 3-2 in favor of Edwards and the Gullatte family, arguing that nurses should still be subject to the duty of care when acting under the supervision of a physician.

“The trial court’s evidentiary ruling, and the Court of Appeals’ affirmance of it, was dictated by the application of the principle entrenched by Byrd … and its progeny which categorically establishes that nurses do not owe a duty of care in the diagnosis and treatment of patients while working under the supervision of a physician licensed to practice medicine in North Carolina,” wrote Justice Michael Morgan for the state Supreme Court’s 3-2 majority.

“Due to the evolution of the medical profession’s recognition of the increased specialization and independence of nurses in the treatment of patients over the course of the ensuing ninety years since this Court’s issuance of the Byrd opinion, we determine that it is timely and appropriate to overrule Byrd as it is applied to the facts of this case.”

Dissenting Justice Tamara Barringer took issue with the majority’s decision.

“In judicially changing this standard, the three-justice majority appears to create liability without causation — allowing a nurse to be held liable for negligent collaboration in the treatment ultimately chosen by the physician. Such a policy choice should be made by the legislature, not merely three Justices of this Court,” Justice Barringer wrote.

Critical care nurse and legal consultant Ashley Hughes said the state legislature should be the one to ultimately decide whether nurses can be held accountable for following a doctor’s orders, considering the implications for the healthcare industry.

“None of the judges are in the healthcare arena. So that’s very dangerous to me,” Hughes said. “To make decisions, especially about the standards of care without going through the due processes of going through the General Assembly.”

Hughes added that nurses already strive to provide the best possible care for their patients, but they can only do so much amid the existing staffing crisis. She also believes the ruling will make the shortage even worse.

“They’re already short-staffed. On top of that, there is the issue of violence against nurses, nurses are being attacked. There’s the issues about the pay nurses not being paid appropriately,” Hughes said. “Along with that, criminally, nurses now are being held more on a criminal level, rather than just civil.”

But the ruling was seen as a victory for Gullatte, who will never be the same after the procedure.

“She’s now 15 years old, and she has to be taken care of 24/7,” Edwards said. “Her mom, her grandparents, they spend their whole lives taking care of her. So, this was going to go on for a long time for her, she needed help.”